As is well known, prescriptions are used by a physician, dentist, podiatrist, optometrist, and/or other medical professional with prescribing powers under applicable state law (a “prescribing professional”) to prescribe one or more drugs and/or other medical devices (“drugs”) for a patient. Via a prescription, a prescribing professional conveys, transmits, or otherwise provides information regarding certain prescription elements to one or more persons and/or entities who will fulfill the prescription and dispense the prescribed drug. Prescription elements may include: (1) patient elements, (2) drug elements, (3) dispensing elements, and/or (4) prescriber elements.
Patient elements may include patient identification elements, such as name, address, the age, date of birth, and/or gender. A unique identifier, e.g., a unique number created for a patient by a pharmacy, may be a patient identification element. Patient elements may also include patient health care coverage elements, such as insurer, policy number, group insurance and/or member number, employer, and/or health plan administrator. Finally, patient elements may include patient health elements such as chronic health conditions, prescription drug history, and/or other medical history.
Drug elements might include items such as the name of the drug; the strength; the form; instructions to the patient regarding how, how much, when, and for how long the drug should be administered (e.g., the “Sig”); and/or other information regarding the prescribed drug, such as compounding instructions. Other drug elements might include information not typically provided directly with a prescription, but obtainable based on information that is provided with the prescription, such as a national drug code (“NDC”) number; a generic code number (“GCN”), referring to a number assigned to each drug by First Data Bank, Inc.; and/or a generic product identifier (“GPI”), referring to the number provided by Medi-Span (a part of Wolters Kluwer Health).
Dispensing elements may include, inter alia, the quantity prescribed, the quantity dispensed, the number of days' supply, the number of refills, whether generic substitutions are permitted, e.g., whether or not the prescription must be “dispensed as written” or “DAW.”
Prescriber elements refers to information about the prescribing professional, such as name, address, Drug Enforcement Agency (“DEA”) number, facsimile number, medical group (or other professional association), and the like.
A prescription will include and/or otherwise provide “prescription element information,” i.e., information specific to a plurality of prescription elements. Prescription element information may be provided by one or more data points specifically included in the prescription, e.g., a patient's name. In other instances, prescription element information may be obtained, identified, or otherwise established based on one or more data points specifically included in the prescription, e.g., a patient's name and address may be used by a pharmaceutical professional to obtain, identify, or otherwise establish a patient's identification number. By way of further example, drug name, form, and strength may be used to establish the NDC of the prescribed drug.
Thus, references to “prescription element information” should be broadly understood and refers to and includes information (e.g., one or more data points) obtained, identified, or otherwise established, directly or indirectly, from a prescription that is relevant to one or more specific prescription elements. Furthermore, references to prescription element information for a particular prescription element refers to such prescription element information regardless of the format such information may take, e.g., human-readable, computer-readable, or otherwise. A particular prescription may omit information for some prescription elements.
It is generally understood that “processing a prescription” typically begins with a prescribing professional deciding upon or otherwise selecting a drug for a patient and typically ends with receipt by the patient, the patient's caregiver and/or other representative of the patient (collectively and/or individually, unless the context otherwise requires, the “patient”) of the drug.
“Prescription” as used herein should be broadly understood to refer to and include any method by which a prescribing professional does and/or may prescribe one or more drugs for a patient, regardless of the form or manner of the prescription and regardless of whether the prescription is in tangible form, intangible, or both. Furthermore, reference to “a prescription”, “the prescription”, and the like should be broadly understood to refer to and include any and all manifestations and/or embodiments of that prescription. Thus, if a prescribing professional faxes a written prescription to a pharmacy, which the pharmacy then uses to create an electronic version of the prescription, “the prescription,” “a prescription,” and the like shall refer to any and all copies, versions, and/or embodiments of such prescription and/or the prescription element information of such prescription, unless the context specifically requires otherwise.
Typically, processing a prescription will include one or more steps via which a pharmacist, often with assistance of other professionals (pharmacists and/or such other professionals are referred to herein individually as a “pharmaceutical professional”) and often working at or for a pharmacy, will evaluate, fill, and/or dispense a prescribed drug to a patient. Of course, a pharmaceutical professional may provide other services, such as counseling the patient and/or assisting with therapy compliance. Processing a prescription may also include one or more steps, (1) in which a patient's health insurance is evaluated to determine, e.g., whether the prescribed drug is covered by the patient's health insurance; (2) in which a claim is made with one or more health insurance companies, drug manufacturers, and/or distributors for payment or partial payment; and/or (3) in which payment from the patient is received or otherwise processed.
The details of how a prescription gets from a prescribing professional to a to pharmaceutical professional vary widely. In some instances, the patient may act as an intermediary; for example, a prescribing professional may give a written prescription to a patient who then delivers it to a pharmacy and/or pharmaceutical professional in person or who otherwise transmits, conveys, or delivers the prescription to a pharmacy and/or pharmaceutical professional. In other instances, a prescription may be transmitted, conveyed, or otherwise delivered to a pharmacy and/or pharmaceutical professional more or less directly by a prescribing professional For example, a prescribing professional may submit an electronic prescription, e.g., via the Internet or other wired or wireless system in communication with a system accessible at or by a pharmacy and/or pharmaceutical professional; a prescribing professional may submit a prescription via telephone; and/or a prescribing professional may fax, mail, and/or otherwise transmit, convey, or deliver a prescription to a pharmacy and/or pharmaceutical professional. Again, “the prescription” delivered to the pharmacy and/or pharmaceutical professional may refer, for example, to a written prescription given or otherwise delivered to the patient by the prescribing professional or it may refer to a duplicate of that prescription, such as a facsimile or other electronic copy and/or to an alternative embodiment of some or all of the information provided by that prescription, i.e., to some or all of the prescription element information associated with one or more prescription elements.
In some instances, a prescribing professional may dispense and/or administer a drug directly to a patient.
Similarly, the details of how a prescribed drug gets from a pharmacy or prescribing professional to a patient may vary. The patient may pick up the prescribed drug at a pharmacy (which may or may not be the pharmacy by which the prescription was originally received), physician's office, hospital, or other location. Alternatively, the pharmacy may deliver the prescribed drug to the patient via mail, messenger service, or otherwise.
Verification of a prescription by a pharmaceutical professional and/or verification by a pharmaceutical professional that a dispensed drug is the prescribed drug are common steps in processing a prescription, and such verification steps help minimize errors in processing prescriptions. However, not all errors are readily detectable via such verification steps and, in any event, errors can and do occur at any one or more of the steps that may be involved in processing a particular prescription, sometimes with serious consequences.
Errors in processing a prescription can occur when a prescribing professional creates the prescription; for example, the prescribing professional may include prescription element information that is incorrect. Other errors may occur after a prescription has been received by a pharmacy and/or pharmaceutical professional has received a prescription; for example, correct prescription information from the prescription may be incorrectly entered upon creation of an electronic version of the prescription to become incorrect prescription element information. “Errors” may also refer to instances in which the prescription element information provided by the prescribing professional is “correct”, e.g., it accurately reflects the intent of the prescribing professional and is correctly entered and/or processed by pharmaceutical professionals, but administering the prescribed drug, at the designated strength, form, and/or in accordance with the instructions would be inappropriate, unsafe, and/or otherwise undesirable, either generally or for the particular patient—such errors may be referred to as “misprescribed drug errors”
Thus, a need exists for methods of processing prescriptions that (1) minimize errors in processing and/or filling prescriptions and/or in dispensing drugs by a pharmacy and/or pharmaceutical professional, (2) improve identification of incorrect prescription element information, and/or (3) improve identification of misprescribed drug errors.
In addition, a need exists for methods of processing prescriptions that are more efficient than prior art methods and that maximize the benefits of the skills and training of pharmaceutical professionals.